Magnetic Resonance Imaging Has Role in Cardiac Workup

Imaging modality may sometimes replace imaging with invasive angiography or ionizing radiation

22 aug 2009-- Patient workup using cardiovascular magnetic resonance (CMR) imaging is indicated for several major cardiac conditions and can have a substantial impact on diagnosis and patient management, according to a study published online Aug. 12 in the Journal of the American College of Cardiology.

Oliver Bruder, M.D., of Elisabeth Hospital in Essen, Germany, and colleagues studied 11,040 patients from 20 medical centers in the European Cardiovascular Magnetic Resonance registry to evaluate the routine use of CMR, including indications for use, image quality, safety, and impacts on patient management.

The researchers found that the indications for CMR included myocarditis and cardiomyopathy (32 percent), risk assessment in suspected coronary artery disease and ischemia (31 percent), and assessment of myocardial viability (15 percent). CMR image quality was good in 90.1 percent of cases, moderate in 8.1 percent, and unsatisfactory in 1.8 percent. Patient management was affected in 62 percent of cases, and in 16 percent the final diagnosis based on CMR was different from the pre-CMR diagnosis, resulting in a major change in management.

"Consequently, CMR stress testing for risk stratification in suspected coronary artery disease may have the potential to significantly bring down the number of diagnostic coronary angiographies that do not result in intervention or surgery in the future. In addition, nearly 700 noninvasive procedures involving the use of ionizing radiation, such as SPECT imaging, could also be avoided on the basis of the CMR results," the authors write.

The EuroCMR Registry is funded by unrestricted educational grants from Medtronic Inc., Novartis International AG, Servier Societe, and Siemens Healthcare.

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